Provider Demographics
NPI:1023839602
Name:WHITEHEAD EYE CARE PLLC
Entity type:Organization
Organization Name:WHITEHEAD EYE CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:WHITEHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:830-688-6323
Mailing Address - Street 1:708 HILL COUNTRY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-6071
Mailing Address - Country:US
Mailing Address - Phone:830-688-6323
Mailing Address - Fax:
Practice Address - Street 1:708 HILL COUNTRY DR STE 100
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-6071
Practice Address - Country:US
Practice Address - Phone:830-688-6323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-17
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty